Suture Anchor Device, Kit and Method

ABSTRACT

A suture anchor and kit for anchoring a suture member to human bone in an interference fit. A suture anchor includes a threaded portion and has a head at the proximal end thereof, the head being generally circular. A tip is located at a distal end of the shank. The shank is at least partially threaded and includes walls defining a reel portion. The shank also includes walls for engaging a suture, the walls for engaging the suture typically adjacent walls defining the reel portion. The head typically includes walls for engaging a drive tool. The kit includes a drive tool for rotating the suture anchor when a suture member is engaged with the walls for engaging the suture such that rotation of the anchor causes the suture material to wrap around the reel portion of the shank.

RELATED APPLICATIONS

This patent application is a continuation U.S. patent application Ser.No. 13/107,419, filed May 13, 2001 and incorporated herein by reference,which is a continuation of U.S. patent application Ser. No. 11/637,383,filed Dec. 12, 2006, now issued as U.S. Pat. No. 7,959,649 andincorporated herein by reference, which is a continuation-in-part ofU.S. patent application Ser. No. 10/412,205, filed Mar. 31, 2003, nowabandoned, and incorporated herein by reference; which is a continuationof U.S. patent application Ser. No. 09/825,110, filed Apr. 3, 2001 andnow issued as U.S. Pat. No. 6,540,750; which is a continuation of U.S.patent application Ser. No. 09/322,371, filed May 28, 1999 and nowissued as U.S. Pat. No. 6,267,766.

FIELD OF THE INVENTION

Applicant's invention relates to a device, method and kit for repairingtissue, namely for selectively positioning a suture-bearing tissueadjacent a bone mass.

BACKGROUND OF THE INVENTION

When soft tissue, such as tendons and ligaments, are torn away from thebone, surgery may be required to repair the tear. Typically, a suturemember is threaded through the torn tissue and through a tunnel drilledin the bone mass. The suture material is drawn up and tied so that thetorn tissue lays adjacent the bone mass in proper position to heal.

A number of assemblies have been provided to anchor tissue to a bonemass. These devices are usually attached to the bone mass through theuse of open incisions or, sometimes, arthroscopic surgical techniques.Arthroscopic surgery is advantageous compared to the use of open surgerybecause of the decreased pain and quicker recovery period. However, theinvention may be used advantageously with open surgery as well.

The various assemblies used for attaching soft tissue to the boneinclude screws, staples, suture anchors, cement, and sutures alone. Thesuture anchor is a small device, typically insertable arthroscopicallythrough a cannula to the repair site to anchor the suture to a bone.

That is, a suture is passed through the soft tissues and inserted into asuture anchor in the base. Such a suture anchor assembly is disclosed inU.S. Pat. No. 5,683,419. This suture anchor assembly includes two maincomponents: an anchor sleeve, which can have a closed pointed drill endor be totally cylindrical in shape, ribbed, or threaded on its exteriorfor attachment to the bone; and a spike or plug with one end that allowsfor easy puncturing of soft tissue and a second end for attachment ofthe suture material. The pointed first end of the spike or plug allowsit to be insertable to the sleeve, which sleeve has been inserted intothe bone.

A second device is disclosed in U.S. Pat. No. 5,904,704 and includes asuture anchor assembly, including a suture anchor and a tool fordeploying the suture anchor in the bone. The suture extends from and isanchored to the bone. The suture anchor has a drill portion and a threadportion, and a suture attachment portion distal to the pointed portion.

None of the prior art provides for a suture anchor that includes a reelportion adjacent suture-receiving walls in a manner that allows thethreading of the anchor member into the bone while the suture materialsimultaneously winds around the reel portion of the suture anchor todraw up the suture and the corresponding soft tissue to which the sutureis engaged so as to selectively position the soft tissue adjacent thebone.

None of the prior art shows a reel portion capable of providing aninterference fit of suture between the bone and anchor.

Applicant provides a unique suture anchor, including a reel portionthereon, a unique method of using the suture anchor to selectivelyposition, by rotation of the suture anchor and gathering the suturematerial on the reel portion thereof, the suture bearing tissue, and anovel kit providing a suture anchor and a tool for rotating the sutureanchor. Applicant's device may be used without the necessity of tyingsuture knots arthroscopically or, indeed, may be used without tyingsuture knots at all.

Applicant's novel suture anchor, method, and kit overcome problemsencountered in prior art suture anchors and provide a relatively easymethod of arthroscopically reattaching torn or displaced tissue to abone mass.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side elevational view of the suture anchor of Applicant'spresent invention holes in any non-head portion.

FIG. 2 is a top elevational view of the suture anchor of FIG. 1.

FIG. 3 is a side perspective view of a shoulder C (partially cut-away)having torn tissue A therein, having a bone mass B, the shoulder openthrough an incision through which is inserted a cannula D, theperspective view illustrating the engagement of suture material 40 tosuture anchor 10.

FIGS. 3A and 3B illustrate perspective views of the shoulder (partiallycut-away) illustrating two steps of Applicant's present invention.

FIG. 4 is a view of the shoulder C of FIG. 3 which illustrates the useof Applicant's tool 30 for engaging the anchor 10 as the anchor isinserted into bone B, the perspective view also illustrating the use ofan out-rigger 26 on the tool to help guide the suture.

FIG. 5 is an illustration of an additional hook tool 60 for use withApplicant's present invention.

FIG. 6 illustrates the shoulder mass and tissue after the tissue hasbeen selectively located adjacent the bone by reeling surgery materialonto the suture anchor in the manner set forth in Applicant's presentinvention.

FIG. 7 shows an embodiment with a reel portion located along the shanknear the tip although the reel could be located anywhere along theshank.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

In viewing FIGS. 1 through 3 it is seen that Applicant's presentinvention includes a unitary, longitudinal suture anchor 10, typicallymade of titanium, stainless steel, plastic, allograft bone, or othersuitable material, including a bio-absorbable material. The sutureanchor is seen to have a generally circular head 12, the head typicallyhaving an outer edge 12A, an upper surface 12B, and walls 12C forengaging any type of mating tool as set forth in more detail below.

Applicant's novel suture anchor 10 includes a shank portion 14 locateddistal to the head 12, the shank portion 14 having threads 16 on atleast a portion thereof, the shank portion 14 terminating at a tip 18.The shank portion 14 also includes a reel portion 22, typically havingadjacent walls 23 defining a suture receiving portion. The particularconfiguration of the walls 23 here include a pair of holes 24 going fromone portion of the outer surface of the shank portion 14 to a secondportion of the outer surface of the shank portion 14 (see FIG. 2)transverse to the longitudinal axis of the shank portion 14 and beingdimensioned to receive a suture member 40 therethrough. That is, theholes are in a non-head portion of the anchor.

The reel portion 22 typically has raised upper walls 23 proximal(towards the head 12) adjacent thereto to keep the gathered suturemember 40 from slipping off the top of the wall 23. It may also havelower walls 13 which, in conjunction with upper walls, help keep thesuture winding on the anchor. It is noted that the lower walls in theembodiment illustrated in FIGS. 1-3 have about the same radius as theupper walls, while the lower walls in the embodiment illustrated in theremaining figures have a diameter less than the upper walls.

FIGS. 1 and 2 also illustrate how the tool 30, such as the toolillustrated in FIG. 4, is used to the engage walls 12C of the head 12 ina manner such that, when the tool 30 (see FIG. 4) is engaged with thesuture anchor 10 and, further, while the suture member 40 is engagedwith the walls 23 of the shank portion 14, the suture member 40 willgather on the reel portion 22 of the suture anchor 10. Further, sincethe suture member 40 was previously engaged with, as by threading atissue A (see FIG. 3A illustrating open surgery rather thanarthroscopic, a suture passer would be used in arthroscopic surgery)before being engaged with the suture member 40, rotation and gatheringof the suture member 40 on the reel portion 22 of the suture anchor 10will cause the tissue to move closer to the suture anchor 10 while thesuture anchor 10 is being driven into bone, so as to simultaneouslyaffix the suture anchor 10 to the bone and gather the suture member 40onto the suture anchor 10 to position the tissue adjacent the bone at apredetermined location.

FIG. 6 illustrates the use of Applicant's novel method, device, and kitwhen the task of reeling up suture material is completed so as positiontissue A against or adjacent bone mass B at a predetermined positionflush with bone or countersunk to produce an interference fit with thesuture material between the anchor and the bone. Alternatively, aportion of the reel portion may be left above the surface of the bone.

It is anticipated that Applicant's novel method, device and kit is bestutilized with arthroscopic techniques through the use of cannula D, hereillustrated for use on a shoulder, but capable of being used anywhere inthe body where tissue is needed to be attached to a bone mass. Indeed,Applicant's method and system can be used in open surgery as well asarthroscopically. When used in arthroscopic surgery, the suture anchor10 is usually dimensioned suitable to fit within the cannula D, as isthe tool 30.

As shown in FIG. 5, a hook device 60 may be inserted through the cannulaD and used when either additional suture material 40 needs to be takenup and wound around the reel manually, as when the suture anchor 10 isalready seated into the bone, and the tissue needs to be brought yetcloser to the anchor. Likewise, suture material may be unwound onecourse at a time if the surgeon feels it is necessary to allow thetissue to move further from the inserted suture anchor 10.

The following describes the novel method (open or arthroscopic) of useof Applicant's present invention. The repair site is first located aftera small incision and insertion of the cannula D through the skin. Thesuture member 40 is threaded onto a needle (open surgery) or suturepasser (arthroscopic surgery), which is transported to the repair site.The suture-bearing needle or arthroscopic instrument is passed throughthe tissue, and then the suture member 40 and the needle are removedthrough the cannula D. The suture member 40 is then engaged with thesuture anchor 10 by, for example, inserting through the holes 24 in thesuture anchor 10 and tied off or pulled through the hole (FIG. 3).Alternatively, the suture may pass through the hole and not be tied, butsimply wound around the reel portion for a friction fit to the anchor.Next, the suture anchor 10 is transported through the cannula D to therepair site and placed adjacent the bone mass positioned selectively sothat rotation and insertion of the suture anchor 10 into the bone mass,while the suture member 40 is winding onto the reel portion, will locatethe tissue at a predetermined location adjacent the bone mass. If theanchor is made from a bioabsorbable material, the bone is typicallypre-tapped before inserting the anchor.

Having selected the appropriate location adjacent the bone mass, thetool 30 is then inserted through the cannula D and engaged with the headof the suture anchor 10. Rotation by manually rotating the handle of thetool 30, while urging the suture anchor 10 against the bone, will seatthe suture anchor 10 while the suture member 40 winds onto the reelportion 22 of the suture anchor 10. Rotation continues until the tissueis properly positioned adjacent the bone mass with anchor sunk untilhead upper surface is flush with cortex of bone or countersunk (see FIG.6). This provides an interference fit holding the suture between thebone and the reel portion so the suture material will not unwind.Alternate procedures, such as using the hook tool 60 through the wind orunwind courses of the suture member 40 onto the reel portion 12, used ifnecessary. The tool 60 and the cannula D are then removed and the woundclosed in accordance with procedures known in the art.

The surgeon may estimate the amount of take up required on the suturematerial to properly locate the tissue. Knowing the approximate diameterof the reel portion, the surgeon may adjust the pre-drilling length ofsuture between the anchor and the tissue so that when the anchor iswound into the bone to the position set forth in FIG. 6, the tissue isproperly positioned.

FIG. 7 illustrates an embodiment wherein reel portion 12 is anywherealong the shank portion. The interference fit of the suture between theanchor and the bone will be greater as the reel is positioned closed tothe tip.

Although the invention has been described with reference to specificembodiments, this description is not meant to be construed in a limitedsense. Various modifications of the disclosed embodiments, as well asalternative embodiments of the inventions will become apparent topersons skilled in the art upon the reference to the description of theinvention. It is, therefore, contemplated that the appended claims willcover such modifications that fall within the scope of the invention.

1. A method of anchoring tissue to bone using suture comprising thesteps of: providing an anchor driver; providing an anchor having a headportion with walls adapted to receive an anchor driver and a shankportion with outer walls, the shank with a channel therein, the channelconnecting openings in the outer walls of the shank; engaging the sutureto the tissue; threading suture so it is entrained in the channel of theanchor; placing the anchor against the bone; and inserting the anchorinto the bone such that the suture lies wedged between and substantiallycontacting the bone and the walls of the anchor in an interference fit.2. The method of claim 1, wherein the inserting step positions theanchor such that the head is below a surface of the bone.
 3. The methodof claim 1, wherein the inserting step positions the head about flushwith a surface of the bone.
 4. The method of claim 1, wherein theinserting step is preceded by the step of coupling the anchor driver tothe head of the anchor.
 5. The method of claim 1, wherein the outerwalls of the shank of the anchor of the providing step include wallstapering to a point and the channel includes at least a pair of openingson the outer walls of the shank.
 6. The method of claim 5, wherein theplacing step includes the step of placing the point against a surface ofthe bone.
 7. The method of claim 6, wherein the inserting step includesurging the point into the bone until the channel openings of the anchorare below a surface of the bone.
 8. The method of claim 1, wherein theinserting step includes the rotation of anchor into the bone.
 9. Themethod of claim 1, further including the steps of providing a cannula;providing a suture passer; and wherein, prior to engaging step, thesuture is threaded to the suture passer and transported through thecannula to the tissue.
 10. The method of claim 1, wherein the suture isengaged to the tissue prior to the threading step, and wherein therotation of the anchor causes the tissue to move closer to the anchor.11. A method of anchoring tissue to bone using suture comprising thesteps of: providing an anchor having a head portion with walls adaptedto receive an anchor driver and a shank portion with outer walls, theshank with a channel therein, the channel connecting openings in theouter walls of the shank; engaging the suture to the tissue; threadingsuture so it is entrained in the channel of the anchor; engaging theanchor driver with the head of the anchor; placing the anchor againstthe bone; and inserting the anchor into the bone such that the suturelies wedged between and substantially contacting the bone and the wallsof the anchor in an interference fit; wherein the outer walls of theshank of the anchor includes walls tapering to a point and the channelincludes at least a pair of openings on the outer wall of the shank;wherein the placing step includes the step of placing the point of theanchor against a surface of the bone; and wherein the inserting stepincludes urging the point into the bone until the channel openings arebelow a surface of the bone.
 12. The method of claim 10, wherein theinsertion of the anchor includes the rotation of the anchor into thebone.
 13. The method of claim 11, wherein the suture is engaged to thetissue prior to the threading step, and wherein the rotation of theanchor causes the tissue to move closer to the anchor.
 14. The method ofclaim 11, further including the steps of providing a cannula; providinga suture passer; and wherein, prior to engaging step, the suture isthreaded to the suture passer and transported through the cannula to thetissue.
 15. A method of anchoring tissue to bone using suture comprisingthe steps of: providing an anchor comprising a head portion at a nearend thereof with walls adapted to receive an anchor driver; and, a shankportion with outer walls, the shank with a channel therein, the channelconnecting openings in the outer walls of the shank, the shank includinga pointed tip; engaging the suture to the tissue; threading suture so itis entrained in the channel of the anchor; placing the anchor againstthe bone; and inserting the anchor into the bone such that the suturelies wedged between the bone and the walls of the anchor in aninterference fit so the suture directly engages both the bone and wallsof the anchor, wherein the inserting step moves the anchorlongitudinally into the bone, the inserting step continuing until theanchor head and at least a portion of the suture is at or below the bonesurface.
 16. The method of claim 15, wherein the anchor defines apointed tip at a removed end thereof and wherein the inserting stepincludes the step of urging the pointed tip into the bone.
 17. Themethod of claim 15, further including the steps of providing a cannula;providing a suture passer; and wherein, prior to engaging step, thesuture is threaded to the suture passer and transported through thecannula to the tissue.